Forefoot inflammation in recent-onset ACPA-positive and ACPA-negative rheumatoid arthritis (RA): clinically similar, but different in underlying inflamed tissues
Main finding · Forefoot involvement at diagnosis: joint counts, walking disabilities and MRI-inflamed tissuesResult — go to the resultMean SJC 8 vs 6Authors' conclusion
Although the forefoot of ACPA-positives and ACPA-negatives share clinical similarities at diagnosis, there are differences in underlying inflamed tissues.
Study context
- Population
- Consecutively diagnosed patients with recent-onset RA, assessed at diagnosis
- Participants
- 171 vs 203
- Exposure
- ACPA-positive vs ACPA-negative RA
- ACPA-positiven = 171
- ACPA-negativen = 203reference
- Outcome
- Forefoot involvement at diagnosis: joint counts, walking disabilities and MRI-inflamed tissues
- Follow-up
- At diagnosis
Methodological detailsconsecutively diagnosed patients, MRI of metatarsophalangeal (MTP) joints, age-matched healthy controls used to define MRI abnormalities
- Consecutively diagnosed patients
- MRI of MTP joints
- Age-matched healthy controls used to define MRI abnormalities
Main finding
As reported in the abstract
Mean SJC
8 vs 6
P = 0.003
- Walking disabilities equally common
- 49% vs 53%
Observational data: associations, not effects.
Further findings
Association of intermetatarsal bursitis (IMB) with MTP-joint swelling and tenderness within ACPA-positive RA
| Estimate | ||
|---|---|---|
| IMBIndependent association | OR (MTP-joint swelling) 2.6 (95% CI 1.4–5.0) | |
| IMBIndependent association | OR (MTP-joint tenderness) 3.0 (95% CI 1.8–5.0) | |
| 0.20.5125Ratio (log scale) |
Association of synovitis with MTP-joint swelling and tenderness within ACPA-negative RA
| Estimate | ||
|---|---|---|
| SynovitisIndependent association | OR (MTP-joint swelling) 2.8 (95% CI 1.4–5.8) | |
| SynovitisIndependent association | OR (MTP-joint tenderness) 2.5 (95% CI 1.3–4.8) | |
| 0.20.5125Ratio (log scale) |
Contributors to walking disabilities
- Tenosynovitis contributed most to walking disabilities
Original publication
Forefoot inflammation in recent-onset ACPA-positive and ACPA-negative RA: clinically similar, but different in underlying inflamed tissues. RMD Open. Published 2 October 2024. doi:10.
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